INTRODUCTION:

Substance (drug) abuse is now considered as a global problem and a curse to mankind. Adolescence is a transitional stage of physical and mental human development with substantial risk for initiating substance use. Reproductive and Child Health Program mentions adolescents as being between 10-19 years of age (UN system in India, 2003). Nearly 20% of Indian population is adolescent (UNICEF’s report, 2011) with 1.2 billion adolescent population in the world.¹

These are the most common seen substance (drug) abuse products: alcohol, heroin, cocaine, tobacco (cigarette smoking) like; cigar, zarda, gutkha. The causes for this bad habit of drugs are poor parental role, peer group influence, low social economic status, and media through advertisements of the products.

The commonly seen effects of these substance abuse are physical (poor self-care, body organ damage, respiratory distress and loss of weight), mental (poor cognitive, memory loss, poor judgment, depression, stress and brain damage) and social problems (poor quality of life, self withdrawal from family and friends). ²

Tobacco use is major preventable cause for death in many parts of the world today (WHO, 2004) most of the regular smokers initiate smoking habit in their adolescent period of life

The national household survey of drugs and alcohol abuse in India (2002) reported that 55.8% of tobacco users belonged to the age group of 12-18. It was observed that the prevalence of tobacco user was increased as the age advanced and more than 50% of smokers begin to smoke during their adolescent period .This finding is supported by global growth tobacco survey fact sheet had shown that 25% of students of 13-14yrs experienced one or other form of tobacco.³

NEED FOR THE STUDY:

About 200 Million people worldwide use illegal drugs each year according to new report which caused a quarter million deaths per year most seen in developed countries.

The majority of drug users begin the habit of using the products in their teenage life before reaching 18 years which is determined as maturity age. It is predicted that the patterns of using substance abuse that is seen now continues to life time. The result leads to death of young and adult people mostly in developing countries.

Teenagers in schools are also concerned with this diseased trend of using harmful drugs by their peers eventually they join in the bad habits like smoking, drinking alcohol.³

The current estimated of deaths due to these harmful substances (drugs) are as follows;

Estimates

In 2004, WHO suggested that 250,000 deaths worldwide was due to elicit drugs, 2.25 million due to alcohol, 5.1 million due to tobacco

In 2012, the latest estimates from the NHS health and social care is 79,100 people died in England due to smoking and 8,748 people died from alcohol.

Worldwide Burden

The Researchers, who uses information from United Nations office on drug and crimes, estimated that between 149 million and 27i million people worldwide use illegal drugs.

The harmful use of alcohol and tobacco is a global problem which compromises individual and social development. It results in 2.5 million deaths each year due to physical and psychological effects to drug users.

· 320,000 young people aged 15-29 years

· 440,000 deaths annually

· Active smokers - 269, 655 deaths annually for men and 173, 940 female annually.

· Passive smoking - 49,400,000 deaths per year.⁶

India

Tobacco use usually begins in adolescents; the time of their observation, understanding, struggling, facing challenges and psychological development. Prevalence of tobacco use in India is continuously increasing but there are considerable changes in the methods of its use. According to WHO estimates, about 194 million men and 45 million women use tobacco in smoked or smokeless form in India. Information on prevalence of tobacco use is available from several studies, which shows a great deal of variation by region, social customs, gender and form of tobacco consumption. Tobacco is the second major cause of death in the world. WHO sources emphasizes the rate of tobacco consumption especially in developing countries as an epidemic. Tobacco death toll is expected to double by 2025 from the present 5 million deaths (approx). At every 6.5 seconds, one dies because of tobacco related disease globally. This is occurring mostly in developing countries like India, adding significantly to their burden of disease, poverty and economy. ⁵

STATEMENT OF THE PROBLEM:

A study to Assess knowledge regarding substance abuse among adolescents at selected PUC colleges in Belgaum city.

OBJECTIVES OF THE STUDY:

· To assess the knowledge regarding substance abuse among adolescents at selected PUC colleges in Belgaum city.

· To find out the Association between knowledge on substance abuse with selected demographic variables of adolescents.

OPERATIONAL DEFINITIONS:

1. Assess: In this study, it refers to gathering of information regarding substance abuse.

2. Knowledge: In this study, it refers to the awareness of substance abuse, types, effects and the expected healthy practices.

3. Substance abuse: It is also known as ‘drug abuse’. In this study it refers to a patterned use of substance (drug) which the user consumes in amounts or with methods neither approved nor supervised by medical professionals.

4. Adolescents: In this study, it refers to a young aged group between 12 to 18 years old.

Assumptions:

· The selected adolescent students in selected schools will have some awareness regarding the ill effects of substance abuse.

· The selected adolescent students in selected schools will have some positive attitude regarding ill effects of drug abuse.

Delimitation:

The study is delimited to,

· Adolescents in the age group of 12 to 18 years.

· Both Adolescents boys and girls.

· Adolescents studying in the selected PUC colleges in Belgaum city.

REVIEW OF LITERATURE:

A cross-sectional study was conducted on knowledge and attitude about substance use among school and college students of class 8, 9 and 10 recruited by using total enumeration method in August and October, 2011 in Chandigarh. A self-reporting questionnaire was used to collect data from a total sample of 192 students. The results shows that, out of these 92 high school students were enrolled from class 8, 9 and 10 and 100 were college students pursuing graduation. Most of the students appeared to have adequate knowledge about addictive substances and their harmful effects but only a minority had knowledge about the available treatment. Again only a minority had negative attitude towards substance abusers and agreed for substance use by themselves or their friends or family. The conclusion shows that, Majority of students had adequate knowledge about harmful effects of addictive substances but had limited information regarding treatment options. This highlight the need for spreading more awareness for prevention as well as treatment of substance related problems.⁷

A cross-sectional study was conducted on social influence of risky drinking and its consequences in 2012 among males from surveyed communities in 2004, 2006, and 2007 from a total samples size of 5,017 current drinkers (2, 619 male) ages 14-20 years from 68 communities surveyed in 2004, 2006, and 2007 by random method. Result shows that, clustering of getting drunk, heavy episodic drinking, and nonviolent consequences was no longer statistically significant after adjustment for drinking with friends and drinking with parents. Parents providing alcohol explained the clustering of heavy episodic drinking and nonviolent consequence. Drinking with friends or other underage drinkers and friends providing alcohol increased the risk of these behaviors, whereas drinking with parents and parents providing alcohol were protective. Perceptions regarding peer drinking, community norms, consequences for drinking, and drinking at a party did not influence clustering. The study suggests that interventions to reduce underage risky drinking in communities should focus on the differential effects of the social context in which drinking occurs^.4

METHODOLOGY:

Research approach and Research design:

A Non-Experimental Design and descriptive approach was used in the study.

Setting:

The study was conducted in the selected PUC colleges in Belgaum city.

Population

The population of the study was professionals of nursing, banking, teaching and pharmacy.

Independent Variable

In this study the independent variables are age, sex, education, type of family, economic status, religion and mass media.

Dependent Variable

Dependent variables in this study are knowledge adolescents.

Sample and Sampling Size:

50 PUC students who were studying in 2^nd year PUC and fulfilled the inclusion criteria.

Sampling Technique

In this study Simple random sampling technique was used.

Description of the Tool

The tools for data collection were developed by the researcher on her own. This self-reporting questionnaire consists of two parts.

Part 1: Comprised Demographic data of PUC adolescent consisted of 10 items.

Part 2: Structured questionnaire to assessment the knowledge on substance abuse among adolescents in the selected PUC colleges in Belgaum city containing 20 questions. These were multiple choice questions helped in assessing the knowledge.

Ethical clearance

The permission was granted from the principal of P.D Bharatesh PU College of commerce and sciences. The samples selected were assured of confidentiality on the information they provided.

RESULTS:

Major findings of the study:

Regarding to their age, 54% were 17 years old and 46% were 18 years old (Fig.1). Male were 23 that represents 46% and females were 27 representing 54%. Regarding their religion 42 were Hindu representing 84%, Muslims were 5 representing 10%, and 3 Jain representing 6% (Fig.2). Father’s education 3 were illiterate representing 6%,primary 19 representing 38%,high school 12 representing 24%,puc 10 representing 20%, diploma/degree 5 representing 10% and 1 post graduate representing 2% (Fig.3). Mother’s education, illiterate were 4 representing 8%,primary 22 representing 44%,high school 15 representing 30%,puc 6 representing 12% and diploma/degree 3 representing 6% (Fig.4). Father’s occupation, 4 were government employees representing 8%, 14 private employees representing 28%, business were 18 representing 36% and 14 collies representing 28%.

Monthly income of their family 10 were earning less than 3000 representing 20%,16 were earning 3001-6000 representing 32%,18 were earning 6001-12000 representing 36% and 6 were earning more than 12,000 representing 12%. Regarding their type of family, 23 were from nuclear families representing 46%, and 27 were from joint families representing 54%. 36 were receives information on television representing 72%, 6 through radio representing 12% and 8 through mass media representing 16%.

Table 1: Describes the frequency and percentage level of knowledge level of the adolescents N=50

Level of knowledge	Score (%)	Frequency	Percentage (%)
Inadequate knowledge	0-49	15	30
Moderate Adequate knowledge	50-74	25	50
Adequate knowledge	75 and above	10	20

Table 1 describes that 30% of adolescents were having inadequate knowledge, 50 % were having moderate knowledge and 20% were having adequate knowledge.

Table 3: Describes the Mean and standard deviation of knowledge on substance abuse among adolescents.N=50

Statistics	Knowledge score
Mean	11.48
Standard deviation	3.781

The above table explains that adolescents have a mean knowledge of 11.48 on substance abuse with standard deviation of 3.781

Association of Demographic Variables with knowledge level of adolescents on substance abuse.

Findings suggests that there is no significant association between level of knowledge on substance abuse among adolescents with demographic variables such as age, education, occupation, economic status, type of family, religion and mode of communication. The findings also suggest that there is an association between knowledge level on substance abuse and sex (gender).

IMPLICATIONS:

The investigator has drawn the following implications from the study which are vital concern to the field of nursing service, nursing administration, nursing education and nursing research.

Nursing Service:

Adolescents must be tactful enough to detect the bad peer group influence at the earliest, So that they can avoid the use of the commonly abused substance (drug) abuse at present during present and in future. The emphasis must be given about the prevention of the bad habit of substance use at the teenage level.

Nursing Administration:

The nursing administrator should see that the health promotion aspect is included in teenage care. The nursing administrator should teach about the harmful health effects of substance abuse and it’s ill outcome. Apart from this, nursing administrator should think of appointing college administrator to educate adolescents and enable them to assess and prevent the bad habit of substance use among the college adolescents.

Nursing Education:

Definite curriculum must emphasize on effective college teaching. This will enable the nurse to get adequate knowledge and skills to motivate for healthful habits that can mould their personality in a right way to be good future professionals.

Nursing Research:

Nursing research should focus on complications substance abuse associated with psychiatric disorders such as depression, anxiety, mood disorders etc. and the effectiveness of educating and training teachers, students in the prevention of substance abuse among teenagers.

RECOMMENDATIONS:

The following studies can be undertaken to strengthen the knowledge and awareness of harmful effects of the common substance abused.

1. The same study can be repeated in different regions of the state or nation so as to compare the results.

2. The same study can be repeated on a large sample so as to generalize the results.

3. Similar kind of study can be conducted among different population such as elderly and middle age both male and females.

A study can be done to assess the practice through different population such as adult, elderly in various professionals.

LIMITATIONS:

A large number of samples could not be taken because of the time constrains.

CONCLUSIONS:

50% of the adolescents were having adequate knowledge compared with 30% of them having inadequate knowledge on substance knowledge. These findings revealed that the right education given on harmful effects of substance abuse if emphasized in a right way by teachers and parents will help to reduce the 30% of adolescents who are having inadequate knowledge on substance abuse.

REFERENCES:

1. Polit D. and Beck C. (2004). Nursing Research-Principles and Methods. 7^th edition. USA: Lippincott Williams and Wilkins Publications.

2. P.S.D.V Prasad Rao, Behavioural Intervention in alcoholism. Psychological research in mental health and neuroscience, article 602 in 1990.NIMHANS Bangalore.

3. A. Sreelal, personality and adjustment of adolescent children of alcoholics. Psychological research in mental health and neuroscience, article 594, NIMHANS- 1994 Bangalore.

4. Jiv Jyot Kaur. A psychosocial study of the adolescent sons of alcohol dependent fathers. Psychological research in mental health and neuroscience, article 589, NIMHANS 1992, Bangalore.

5. Mohan. D, Chopra. A, Sethi. H. The co-occurance of tobacco and alcohol in general population of metropolis Delhi, India. Indian journal of medical research 2002;150-154

6. Colongelo LA, Gupstur SM. Gann PH et al, cigarette smoking and colorectal carcinoma mortality in cohort with long term follow up ,cancer 2004;100;288-293.

7. Surekha Kishore, B.S. Grag, Khursheed Muzammil. Journal of Medical Education & Research vol.9 No 2,April-June 2007; 79

Received on 09.03.2016 Modified on 06.04.2015

Int. J. Adv. Nur. Management. 2016; 4(3): 371-375.

DOI: 10.5958/2454-2660.2016.00066.1